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Teriparatide effective than Alendronate for steroid-induced osteoporosis

Injectable teriparatide (foreto) increases BMD (bone mineral density) by as much as two percent when compared to oral alendronate (fosamax) in a head-to-head comparison, according to a recent study.

It was remarked by Kenneth Saag, M.D., of the University of Alabama at Birmingham and his colleagues, that teriparatide was found in a relationship with enhanced improvements in the level of bone mineral density at the spine and hip.

From Medpagetoday.com:

“In our study, teriparatide was associated with greater increases in [BMD] at the spine and hip and with significantly fewer new vertebral fractures,” Dr. Saag’s group wrote. But the dropout rate for adverse effects was twice as high for those taking teriparatide.

Only one out of 171 evaluable patients receiving teriparatide had radiographic evidence of a vertebral fracture, while 10 of 165 evaluable patients on alendronate had such fractures (P=0.004).

Nonvertebral fractures occurred at similar rates with the two treatments (5.6% versus 3.7%, P=0.36). BMD in the total hip increased with both drugs, though less dramatically than in the lumbar spine. Teriparatide increased hip BMD by 3.8% while it rose 2.4% in the alendronate group. The advantage for teriparatide was significant (P<0.01). Significantly more patients in the teriparatide group had at least one elevated serum calcium measurement > 10.5 mg/dL (18% versus 5.7%, P<0.001) and there was a tendency toward more patients with at least one measurement > 11 mg/dL (3.8% versus 1%, P=0.06).

Teriparatide is a recombinant peptide drug, based on a portion of the parathyroid hormone protein. Earlier studies had indicated that it leads to increased BMD.

Philip N. Sambrook, M.D., of the University of Sydney, said that teriparatide can prove to be a breakthrough option as a potential first-line therapy for steroid-Induced Osteoporosis as per the findings of Saag and his colleagues.

For informational purposes, teriparatide is currently approved for men and postmenopausal women with osteoporosis suffering from the high risk of fractures.

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